Side Effects: Medicaid Reimbursement Crisis Hits Texas

Obamacare promises that, some years down the road, every American will have health insurance. But the whole point of having health insurance is to get medical care when you need it, and that’s not part of the Obamacare promise.

The new law aims to use Medicaid to cover 16 million otherwise uninsured Americans in 2019. But there’s a problem with Medicaid. It reimburses doctors at rates dramatically lower than private insurers do. In fact, it pays doctors far less than even Medicare does. In many cases, Medicaid reimbursement does not even cover the overhead cost of treatment, meaning that physicians actually lose money treating Medicaid patients.

Doctors want to heal patients—but they’re not much interested in paying for the “privilege” of doing so. Already, many physicians simply refuse to see Medicaid patients. They just can’t afford to operate at a loss. And with the advent of Obamacare, the situation is about to get a whole lot worse. Take Texas, for example.

Medicaid, though a federal program, is partially funded by states. And the recession has put a major crimp in state budgets. (Unlike the federal government, most state governments are constitutionally required to maintain balanced budgets.) For states looking to cut spending, Medicaid appears to have a bright, red bulls-eye painted on it.

In Texas, it accounts for 75 percent of the entire budget of the Health and Human Services Commission. As Commission spokeswoman Stephanie Goodman notes, “[W]hen you start to identify places to reduce our budget, it gets very hard to skip Medicaid.”

To help make budget, the Commission is trimming Medicaid reimbursement rates by 1 percent, effective Sept. 1. It’s the first of a series of scheduled cuts. And it will doubtless lead more doctors to drop Medicaid patients.

That’s a big problem. As the Commission notes, even before the rate cut takes effect, “less than a third of the state’s 48,700 practicing doctors accept patients covered by the federal program.”

The Texas Medical Association surveyed its members and found that 45 percent those responding said they would limit how many Medicaid patients they would treat if the fees were “cut by 1 or 2 percent.” Another 24 percent said they would stop accepting Medicaid patients altogether.

As more and more doctors withdraw from Medicaid, more and more Medicaid patients are having trouble finding a physician to treat them. It’s hard to see how the program can possibly deliver health care to an additional 16 million patients dumped into the mix by Obamacare.

Rather than overload an already fractured program, lawmakers should reform Medicaid so that low-income Americans can receive the same quality of care others receive in the private market. For now, the only hope of this happening is in full-on repeal of Obamacare, followed by replacement with something a whole lot better for patients and doctors.

Join The Discussion

Agreed! What isn’t acceptable is some type of federal replacement. Health care, like education and other sought after domestic services are states’ business. Texas does suffer from high uninsured numbers. This said, it’s up to Texans to correct their state’s health coverage needs. Not the federal government doling out pennies on the dollars collected from other states. Texas will take care of its own. My county property tax already pays for indigent care. To Obama and company I say, BACK OFF!

I can’t wait for the first left-wing zealot to cry about how greedy these doctors are. “How dare they concern themselves with profits, when people need medical attention!?” Like it or not, it costs money to do virtually anything in this country. At the very least, the doctor and his nurses/medical assistants need to drive to the clinic (pay for a bus ticket or gas for a car), so they need to make some money to afford salaries, in addition to the gloves, tongue depressors, and electricity bills. Doctors make your quality of life better and deserve to be making the millions professional athletes do, these days. Forced charity (i.e. Medicaid) is not charity. You think it’s bad when businesses move out of the country… just wait until the doctors start going.

Thank you Brad. You're absolutely correct. I'll add that health care is NOT A RIGHT but rather a service. The celebrated author of our U.S. Constitution specifically wrote that such public offerings are the sole province of states and/or local governments. Congress and Obama continue to trash our founding principles corrupting the Republic's federal design. Their priorities are tragically backwards and destructive. As foreign affairs crumble from arrogant neglect, unconstitutional overreach into domestic matters continues unabated.

[…] The Heritage Foundation’s Kathryn Nix, in her “Side Effects of ObamaCare” series, also talks about Medicaid. But she sees a different issue: “As more and more doctors withdraw from Medicaid, more and more Medicaid patients are having trouble finding a physician to treat them. It’s hard to see how the program can possibly deliver health care to an additional16 million patients dumped into the mix by Obamacare.” […]

I couldn't agree with you more!! My husband and I run a Private Pediatric Practice in Michigan. To care for a child with Medicaid the state pays us $144.00 a YEAR We typically see a child 3 to 8 times years. I cannot even cover overhead at that rate!! We have many patients who want the quality health care that our patient centered medical home offers and we have a very reasonable office plan for uninsured patients which at least allows us to cover our costs!! If the child is already signed up on medicaid however we cannot accept any $$ from them or we are in violation of the state!! The government it impossible ro run a medical office!!

Evidentally,although Texas physicians are under-reimbursed by design, Texas Medicaid has a robust advertising budget which allows for multi-media advertising in English and foreign languages touting "free" benefits to the eligible (almost anyone, citizen or not). Likely, this is a Federal requirement. I am being made aware by numerous advisory sources that Physicians are again going to be vigorously targeted and auditied for "fraud" (which is a typical Democrat regime tactic-remember the Janet Reno DOJ reign of terror under Clinton) while the DOJ ignores sleeper terrorist groups ,foreign Mafia etc.Meanwhile patient fraud is something individual physicians are made responsible for. Last week our office manager caught a foreign language speaking individual trying to use his wife's Medicaid card in order to illicitly obtain medical services.He was totally unapologetic and unembarrassed. The extent of fraudulent access to medicare, social security, medicaid benefits by non citizens and rogue citizens and its cost to tax payers and US business must be huge, but since these folks are typical Democrat party constituents,dont expect any "crackdown" on this group.

[…] At the same time that it encourages bad behavior, bailing out Medicaid delays the needed reform to put Medicaid on a fiscal path states can afford—even during a recession. Reform should be a policy priority at both the state and federal level, especially now. Blase explains that “without reform to the federal subsidization of Medicaid, Obamacare—which adds 20 million individuals to Medicaid—will exacerbate Medicaid’s budgetary pressures.” […]

I heard another administration spokesman reiterate that there WILL be rationed

care under the Obamacare Health Plan. So much for "life, liberty and the persuit of happiness." This plan will turn our health care personnel into murderers because the nation cannot "afford" to pay for all. So, that will allow the feds to swoop down on the murdered elders' assests to feed their greed for power and money. Personally, I consider it genocide.

This heartless plan MUST be repealed. Americans for the most part have a

reverence for life abd are compassionate, We can be very proud of this nation and it's accomplishments since its founding.

[…] The Heritage Foundation’s Kathryn Nix, in her “Side Effects of ObamaCare” series, also talks about Medicaid. But she sees a different issue: “As more and more doctors withdraw from Medicaid, more and more Medicaid patients are having trouble finding a physician to treat them. It’s hard to see how the program can possibly deliver health care to an additional16 million patients dumped into the mix by Obamacare.” […]

It is time people learn to give thanks to and for the service that doctors provide rather than just feeling entitled. Part of that thanks is a voluntary exchange called money. Would we expect a farmer to toil in the field all day just to give all of his crop away for free. Well some people probably would, they are called socialists. What would that lead to? No incentive to farm, therefore no food, which would lead to starvation. This makes me mad as hell for one because it screws over the doctors who provide a valuable service and two because it screws over my family with higher health care costs.

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